The Director of Behavioral Health Care Management is the program lead for a team of supervisors, Care Navigators, and Behavioral Health Consultants that support members served through the Care Coordination department. This Director will receive administrative supervision from the Senior Director of Care Coordination. Clinical authority and judgement will be exercised according to the scope of the license held by the employee. Additional clinical supervision will be provided through group peer clinical case reviews and indirectly under the leadership of those clinically credentialed on the Medical Management Team. This Director will define behavioral health outcomes for those served by Alliance Care Teams and collaborate with Utilization Management, Medical Management, and Provider Network leaders within Alliance Health to ensure that the desired outcomes from the work of the Care Navigators and Behavioral Health Consultants are consistent with those established for provider led Care Management Agencies and Tier 3 Advanced Medical Homes. Clinical and administrative supervision will be provided by this Director to Care Navigator and Behavioral Health Consultant supervisors. This position will collaborate with the Directors of Behavioral Health Care Management, Operational Integrity and Regional Initiatives and Staff Development to ensure a cohesive and well coordinate approach to whole person care is achieved for the members served and for the staff working within the department.
Responsibilities and Duties
Reviews, understands and incorporates into departmental practice all DMH and DHB contractual requirements related to care coordination for individuals identified as having specialty behavioral health care needs .
Provides on going education, training and consultation to Care Navigator and Behavioral Health Consultant Care Team Supervisors
Uses a population health management approach when developing policies, procedures and workflows which impact the work of the department
Assists with the development and provision of training for line staff including behavioral health services provided through Alliance Health including all relevant clinical coverage policies, waiver programs, benefits plans and coverages for Medicaid, state funded and special grant programs that may be of benefit to members served through the Care Coordination department
Collaborates with Director of Physical Health Care Management and Medical Management team on development and implementation of clinical decision making workflows. Analyzes population health trends and collaborates with Medical Management on interpretation and business action steps associated with deductions drawn
Represents Care Coordination Behavioral Health Care Management program in Network provider related performance discussions to ensure agreement of desired outcomes across care team, CMA and AMH care management models
Develops workflows and collaborates across Alliance departments to understand data from a variety of sources as this relates to the physical health care risk and need for support of members served
Incorporates knowledge of Alliance health benefit plans and cross departmental structure to help guide efforts of care teams in supporting members with service engagement, assessing impact and seeking resolution of disparities regarding social determinants of health, monitoring census risk stratification for changes that will impact overall management of cases served
Monitors program dashboard in IT system and responds to risks identified
Assists Care Navigator and Behavioral Health Consultant supervisors in the recruiting, hiring and training of staff members
Provides oversight of the behavioral health consultants review of ISPs for Innovations and TBI cases with exceptional behavioral support needs including supporting team consideration of need for enhanced mental health services available which could assist with desired recovery and/or habilitation and rehabilitation outcomes
Exhibits professionalism, enthusiasm, courtesy, adaptability, flexibility, and spirit of cooperation in the work environment
Maintains effective interpersonal relations with Alliance staff, providers, partners and community stakeholders
Provides effective and timely response to phone calls, email and other communications and requests
Performs other related duties as required
Master's degree in mental health, public health, social work, psychology, education, sociology, business or public administration and five (5) years of experience in a community, business, or governmental program in health related fields, social work, or education, including three (3) years of supervisory, consultative or administrative experience.
Requires current NC licensure as a LCSW, LMFT, LPC, LPA , LCAS or RN.
$71,845 - $123,680
3 year(s): Supervisory, consultative or administrative.
5 year(s): In community, business, or governmental program in health related fields, social work, or education.
Masters or better in Human Services
Licenses & Certifications
Lic Clin Addiction Spec
Lic Clinical Social Wkr
Lic Marr & Family Ther
Lic Psychologist (LP)
Lic Psychological Assoc
Lic Prof Counsel (LPC)
Lic Prof Counsel Supv
Thought Provoking: Capable of making others think deeply on a subject
Loyal: Shows firm and constant support to a cause
Leader: Inspires teammates to follow them
Enthusiastic: Shows intense and eager enjoyment and interest
Dedicated: Devoted to a task or purpose with loyalty or integrity
Self-Starter: Inspired to perform without outside help
Job Security: Inspired to perform well by the knowledge that your job is safe
Goal Completion: Inspired to perform well by the completion of tasks
Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization